GC-15: ENDOCRINE PRESENTATIONS AND COMPLICATIONS IN PAEDIATRICS CENTRAL NERVOUS SYSTEM GERM CELL TUMOURS (CNSGCTS)

BACKGROUND: CNSGCTs account for up to 15% of primary paediatric brain tumours in Asian countries. CNS GCTs are characterized with different endocrine problems as they are commonly located near the hypothalamic-pituitary axis. We reviewed the local patients about the endocrine manifestations on presentation and the complications after treatment. METHODS: We carried a retrospective review for paediatrics CNSGCT patients who were diagnosed at less or equal to 18 years old and received treatment in the Lady Pao Children's Cancer Centre, Prince of Wales Hospital during the period January 1996-June 2014. RESULTS: Total 31 patients were diagnosed of CNSGCTs. Twenty patients (65%) were male and 11 (35%) were female. Median age was 12.3 years old. Nineteen patients (61%) had pure germinoma and 12 patients (39%) had non-germinomatous germ cell tumours. The most common location of CNSGCT was pineal region (32%) with 4 patients having bifocal tumour at suprasellar region as well. Five patients (16%) had isolated suprasellar GCT. Thirteen patients (41%) presented with endocrine manifestations including 12 with diabetes insipidus and 5 of them had other endocrine problems including growth failure. Among these patients, 11 patients have their tumors located either along hypothalamic-pituitary axis or at suprasellar region. The patients received biopsy, chemotherapy, radiotherapy or operation to remove the residual or recurrent lesions. Eleven patients (35%) had new endocrine complications including 5 with hypothalamic syndrome on subsequent follow up. CONCLUSIONS: Endocrine manifestations and complications were prevalent among paediatrics CNSGCT patients. Early involvement of paediatrics endocrine subspecialty can contribute to a more comprehensive patient care.